2022
Trends in Use, Outcomes, and Disparities in Endovascular Thrombectomy in US Patients With Stroke Aged 80 Years and Older Compared With Younger Patients
Adcock A, Schwamm L, Smith E, Fonarow G, Reeves M, Xu H, Matsouaka R, Xian Y, Saver J. Trends in Use, Outcomes, and Disparities in Endovascular Thrombectomy in US Patients With Stroke Aged 80 Years and Older Compared With Younger Patients. JAMA Network Open 2022, 5: e2215869. PMID: 35671055, PMCID: PMC9175073, DOI: 10.1001/jamanetworkopen.2022.15869.Peer-Reviewed Original ResearchConceptsSymptomatic intracranial hemorrhageAcute ischemic strokeYounger patientsHospital mortalityCohort studyIschemic strokeOlder patientsIntracranial hemorrhageAmerican Heart Association/American Stroke AssociationFunctional independenceHealth Stroke Scale scoreSymptomatic intracranial hemorrhage rateNationwide retrospective cohort studyGuidelines-Stroke programGWTG-Stroke hospitalsIntracranial hemorrhage rateStroke Scale scoreFavorable functional outcomeRetrospective cohort studyAmerican Stroke AssociationQuality improvement registryMeeting study criteriaEVT rateEVT useThrombectomy trials
2019
Comparison of Clinical Care and In-Hospital Outcomes of Asian American and White Patients With Acute Ischemic Stroke
Song S, Liang L, Fonarow G, Smith E, Bhatt D, Matsouaka R, Xian Y, Schwamm L, Saver J. Comparison of Clinical Care and In-Hospital Outcomes of Asian American and White Patients With Acute Ischemic Stroke. JAMA Neurology 2019, 76: 430-439. PMID: 30667466, PMCID: PMC6459126, DOI: 10.1001/jamaneurol.2018.4410.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAsianBrain IschemiaFemaleFibrinolytic AgentsHealthcare DisparitiesHospital MortalityHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIntracranial HemorrhagesLogistic ModelsMaleMiddle AgedMultivariate AnalysisPatient DischargeQuality of Health CareRetrospective StudiesSeverity of Illness IndexStrokeStroke RehabilitationThrombolytic TherapyTime-to-TreatmentTissue Plasminogen ActivatorTreatment OutcomeUnited StatesWhite PeopleConceptsAcute ischemic strokeAsian American patientsIschemic strokeWhite patientsAmerican patientsClinical outcomesHospital mortalityStroke severityAmerican Heart Association/American Stroke AssociationIntravenous tissue plasminogen activator administrationTissue plasminogen activator administrationMultivariable logistic regression modelGreater stroke severityGuidelines-Stroke programGWTG-Stroke hospitalsIntensive statin therapyOverall stroke incidenceIn-Hospital OutcomesSevere ischemic strokeWorse functional outcomeAmerican Stroke AssociationQuality improvement registryLogistic regression modelsRace/ethnicityStatin therapyMedicare Shared Savings ACOs and Hospice Care for Ischemic Stroke Patients
Kaufman B, O'Brien E, Stearns S, Matsouaka R, Holmes G, Weinberger M, Schwamm L, Smith E, Fonarow G, Xian Y, Taylor D. Medicare Shared Savings ACOs and Hospice Care for Ischemic Stroke Patients. Journal Of The American Geriatrics Society 2019, 67: 1402-1409. PMID: 30835818, DOI: 10.1111/jgs.15852.Peer-Reviewed Original ResearchConceptsIschemic stroke patientsHigher mortality riskHospice enrollmentStroke patientsAccountable care organizationsMortality riskMedicare Shared Savings ProgramComfort measuresLife careIncident ischemic stroke patientsLow-mortality risk groupsGWTG-Stroke hospitalsIncident ischemic strokeMortality risk groupsPalliative care servicesService Medicare beneficiariesQuality of endMedicare hospice benefitSevere strokeIschemic strokePoor prognosisNational registryReduced oddsRisk groupsHospice care
2017
Is Risk-Standardized In-Hospital Stroke Mortality an Adequate Proxy for Risk-Standardized 30-Day Stroke Mortality Data?
Reeves M, Fonarow G, Xu H, Matsouaka R, Xian Y, Saver J, Schwamm L, Smith E. Is Risk-Standardized In-Hospital Stroke Mortality an Adequate Proxy for Risk-Standardized 30-Day Stroke Mortality Data? Circulation Cardiovascular Quality And Outcomes 2017, 10: e003748. PMID: 29021333, DOI: 10.1161/circoutcomes.117.003748.Peer-Reviewed Original ResearchMeSH KeywordsAdministrative Claims, HealthcareAgedAged, 80 and overBrain IschemiaDatabases, FactualFemaleGuideline AdherenceHospice CareHospital MortalityHospitalsHumansMaleMedicarePatient DischargePractice Guidelines as TopicQuality ImprovementQuality Indicators, Health CareRisk AssessmentRisk FactorsStrokeTime FactorsUnited StatesConceptsRisk-standardized mortality ratesHospital mortalityOutlier hospitalsAcute ischemic stroke casesHospital risk-standardized mortality ratesMortality dataGWTG-Stroke hospitalsHospital stroke mortalityIschemic stroke patientsProportion of hospitalsIschemic stroke casesRisk score modelStroke mortality dataChance-corrected agreementComposite outcomeStroke patientsMean ageStroke casesStroke mortalityMedicare filesHospital levelMortality rateLower mortalityHospitalMortality
2016
Association of Get With The Guidelines-Stroke Program Participation and Clinical Outcomes for Medicare Beneficiaries With Ischemic Stroke
Song S, Fonarow G, Olson D, Liang L, Schulte P, Hernandez A, Peterson E, Reeves M, Smith E, Schwamm L, Saver J. Association of Get With The Guidelines-Stroke Program Participation and Clinical Outcomes for Medicare Beneficiaries With Ischemic Stroke. Stroke 2016, 47: 1294-1302. PMID: 27079809, PMCID: PMC4975426, DOI: 10.1161/strokeaha.115.011874.Peer-Reviewed Original ResearchConceptsAcute ischemic stroke admissionsGWTG-Stroke programIschemic stroke admissionsClinical outcomesStroke admissionsMedicare beneficiariesAcute care US hospitalsHospital-based quality improvement programsGWTG-Stroke hospitalsImproved functional outcomesAmerican Heart AssociationQuality Improvement ProgramGWTG-StrokePostdischarge mortalityAcute strokeIschemic strokeFunctional outcomeHeart AssociationNonparticipating hospitalsStroke hospitalsHospital participationUS hospitalsHospitalPre periodSimilar hospitals
2015
Variation and Trends in the Documentation of National Institutes of Health Stroke Scale in GWTG-Stroke Hospitals
Reeves M, Smith E, Fonarow G, Zhao X, Thompson M, Peterson E, Schwamm L, Olson D. Variation and Trends in the Documentation of National Institutes of Health Stroke Scale in GWTG-Stroke Hospitals. Circulation Cardiovascular Quality And Outcomes 2015, 8: s90-s98. PMID: 26515215, DOI: 10.1161/circoutcomes.115.001775.Peer-Reviewed Original ResearchConceptsGWTG-Stroke hospitalsHealth Stroke ScaleNIHSS scoreDocumentation ratesNIHSS dataStroke ScaleMultivariable logistic regression modelAcute ischemic strokeHospital-level factorsPrimary stroke centerImportant prognostic variablesPatient-level predictorsNational InstituteLogistic regression modelsMedian NIHSSIschemic strokeStroke centersThrombolysis candidatesClinical registryPrognostic variablesNIHSSHospitalPatientsStrokeLow documentationLack of Impact of Electronic Health Records on Quality of Care and Outcomes for Ischemic Stroke
Joynt K, Bhatt D, Schwamm L, Xian Y, Heidenreich P, Fonarow G, Smith E, Neely M, Grau-Sepulveda M, Hernandez A. Lack of Impact of Electronic Health Records on Quality of Care and Outcomes for Ischemic Stroke. Journal Of The American College Of Cardiology 2015, 65: 1964-1972. PMID: 25953748, DOI: 10.1016/j.jacc.2015.02.059.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overElectronic Health RecordsFemaleHospital Bed CapacityHospital MortalityHospitals, TeachingHumansLength of StayMaleMiddle AgedOutcome Assessment, Health CarePatient DischargePractice Guidelines as TopicQuality of Health CareStrokeTime-to-TreatmentTissue Plasminogen ActivatorUnited StatesConceptsElectronic health recordsIschemic strokeGWTG-Stroke hospitalsHealth recordsBetter clinical outcomesLogistic regression analysisAmerican Hospital Association Annual SurveyQuality of careOutcomes of interestHigh-quality careGuidelines-StrokeHospital mortalityStroke centersClinical outcomesStroke careSimilar oddsHospital characteristicsOutcome measuresTimely careHospitalPatientsStudy periodCareU.S. hospitalsStroke
2012
Data quality in the American Heart Association Get With The Guidelines-Stroke (GWTG-Stroke): Results from a National Data Validation Audit
Xian Y, Fonarow G, Reeves M, Webb L, Blevins J, Demyanenko V, Zhao X, Olson D, Hernandez A, Peterson E, Schwamm L, Smith E. Data quality in the American Heart Association Get With The Guidelines-Stroke (GWTG-Stroke): Results from a National Data Validation Audit. American Heart Journal 2012, 163: 392-398.e1. PMID: 22424009, DOI: 10.1016/j.ahj.2011.12.012.Peer-Reviewed Original ResearchConceptsMedical recordsDeep venous thrombosis prophylaxisPrimary stroke center certificationGWTG-Stroke hospitalsHospital academic statusStroke center certificationVenous thrombosis prophylaxisNational Stroke RegistryAmerican Heart AssociationQuality Improvement ProgramIntraclass correlationIschemic stroke volumeGuidelines-StrokeGWTG-StrokeStroke RegistryThrombosis prophylaxisNeedle timeSerum creatinineSymptom onsetHeart AssociationCenter certificationStroke volumeRegistry dataRegistry participationCategorical variables
2011
Representativeness of the Get With The Guidelines–Stroke Registry
Reeves M, Fonarow G, Smith E, Pan W, Olson D, Hernandez A, Peterson E, Schwamm L. Representativeness of the Get With The Guidelines–Stroke Registry. Stroke 2011, 43: 44-49. PMID: 21980197, DOI: 10.1161/strokeaha.111.626978.Peer-Reviewed Original ResearchConceptsIschemic stroke admissionsGWTG-Stroke hospitalsGWTG-StrokeMedicare cohortStroke admissionsStroke hospitalsIschemic strokePatient characteristicsMedicare patientsGuidelines-Stroke registryGWTG-Stroke programIschemic stroke populationService Medicare patientsAcute ischemic strokeLength of stayHospital mortalityDischarge homeHospital outcomesAcute strokeStroke populationHospital characteristicsMedicare beneficiariesAdmissionHospitalNational feeAre Quality Improvements in the Get With The Guidelines-Stroke Program Related to Better Care or Better Data Documentation?
Reeves M, Grau-Sepulveda M, Fonarow G, Olson D, Smith E, Schwamm L. Are Quality Improvements in the Get With The Guidelines-Stroke Program Related to Better Care or Better Data Documentation? Circulation Cardiovascular Quality And Outcomes 2011, 4: 503-511. PMID: 21828344, DOI: 10.1161/circoutcomes.111.961755.Peer-Reviewed Original ResearchConceptsGuidelines-Stroke programAtrial fibrillation/flutterIntravenous recombinant tissue plasminogen activator (rt-PA) therapyRecombinant tissue plasminogen activator therapyDeep vein thrombosis prophylaxisTissue plasminogen activator therapyBetter careTarget populationGWTG-Stroke hospitalsIschemic stroke admissionsPlasminogen activator therapyNumber of patientsProportion of subjectsData collection formDischarge antithromboticsEarly antithromboticsThrombosis prophylaxisTreatment contraindicationsEligible subjectsStroke admissionsActivator therapySmoking cessationLipid therapyMeasure complianceContraindications